title: Cognitive distortions in an acutely traumatized sample: an investigation of predictive power and neural correlates.
abstract: BACKGROUND
  Current theories of post-traumatic stress disorder (PTSD) place considerable emphasis on the role cognitive distortions such as self-blame, hopelessness or preoccupation with danger play in the etiology and maintenance of the disorder. Previous studies have shown that cognitive distortions in the early aftermath of traumatic events can predict future PTSD severity but, to date, no studies have investigated the neural correlates of this association.
  
  
  METHODS
  We conducted a prospective study with 106 acutely traumatized subjects, assessing symptom severity at three time points within the first 3 months post-trauma. A subsample of 20 subjects additionally underwent a functional 4-T magnetic resonance imaging (MRI) scan at 2 to 4 months post-trauma.
  
  
  RESULTS
  Cognitive distortions proved to be a significant predictor of concurrent symptom severity in addition to diagnostic status, but did not predict future symptom severity or diagnostic status over and above the initial symptom severity. Cognitive distortions were correlated with blood oxygen level-dependent (BOLD) signal strength in brain regions previously implicated in visual processing, imagery and autobiographic memory recall. Intrusion characteristics accounted for most of these correlations.
  
  
  CONCLUSIONS
  This investigation revealed significant predictive value of cognitive distortions concerning concurrent PTSD severity and also established a significant relationship between cognitive distortions and neural activations during trauma recall in an acutely traumatized sample. These data indicate a direct link between the extent of cognitive distortions and the intrusive nature of trauma memories.
authors.affiliation: Department of Psychiatry, The University of Western Ontario, University Hospital, London, Ontario, Canada.
authors.forename: J K
authors.initials: JK
authors.lastname: Daniels
authors.forename: K
authors.initials: K
authors.lastname: Hegadoren
authors.forename: N J
authors.initials: NJ
authors.lastname: Coupland
authors.forename: B H
authors.initials: BH
authors.lastname: Rowe
authors.forename: R W J
authors.initials: RW
authors.lastname: Neufeld
authors.forename: R A
authors.initials: RA
authors.lastname: Lanius
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000150:complications / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011446:Prospective Studies; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D055815:Young Adult